335P - Real-world data of first-line treatment with pembrolizumab for non-small cell lung cancer with high PD-L1 expression (HOT/NJLCG2001)

Background

It is presently unclear whether pembrolizumab monotherapy (MONO) or pembrolizumab plus platinum-based chemotherapy (COMB) should be selected for patients with advanced-stage non-small cell lung cancer (NSCLC) exhibiting high PD-L1 expression (tumor proportion score ≥50%).

Methods

We performed a retrospective, multicenter study of 300 patients with NSCLC having high PD-L1 expression who received MONO or COMB as first-line treatment between December 2018 and January 2020. We reviewed the medical records of all consecutive patients with no driver mutations, and assessed the patient characteristics, therapeutic regimens, treatment periods, and adverse events.

Results

In total, 166 (55%; median age: 74 years) and 134 (45%; median age: 68 years) patients received MONO and COMB, respectively. Patients were younger and had better performance status (0–1) in the COMB group (p < 0.01). With a median follow-up time of 10.6 months (range: 0.1–20.6), the median progression-free survival was 7.1 months with MONO and 13.1 with COMB. The objective response rate was 42.2% with MONO and 67.9% with COMB. With respect to treatment discontinuation, 36 out of 166 (21.7%) and 28 out of 134 (20.1%) patients discontinued MONO and COMB, respectively.

Conclusions

In conclusion, COMB may be a suitable first-line treatment for NSCLC with high PD-L1 expression.

Clinical trial identification

This study was approved by the Institutional Review Board of all participating institutions (clinical trial registration no. UMIN000040223).

Editorial acknowledgement

Legal entity responsible for the study

2. Division of Cancer Immunotherapy Development, Advanced Medical Development Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

Funding

Has not received any funding.

Disclosure

H. Yokouchi: Financial Interests, Personal and Institutional, Invited Speaker: AstraZeneca, Eli Lilly; Financial Interests, Personal and Institutional, Research Grant: Sanofi, AstraZeneca, Bristol Myers Squibb, Takeda, Chugai, Daiichi-Sankyo, Taiho. All other authors have declared no conflicts of interest.